"The number of COVID-19 positive cases in Chennai might be increasing, but the mortality rate is low. This is because the size of the elderly population getting COVID-19 is not that high," said Dr. Raymond Dominic Savio, Critical Care Consultant, Apollo Hospital, Chennai & Chairman, Indian Society of Critical Care Medicine, Chennai branch.
He added the mortality rate was also low since the percentage of elderly patients, who generally have comorbidities, is less. A higher age group and comorbidities tend to have a fatal outcome for COVID-19.
Speaking to Databaaz, Dr Raymond Dominique Savio and Dr N. Kumarasamy, Chief & Director of Infectious Diseases Medical Centre, Voluntary Health Services (VHS) Hospital discussed the rising cases of COVID-19 in Tamil Nadu, and the implications it had for the state, including a total lockdown in Chennai and three neighbouring districts from June 19 until June 30.
Dr Kumarasamy points out that though Chennai has a high number of cases, the true prevalence will not be known, because testing is very low. The only people who get tested are the ones coming to the hospital.
"If asymptomatic people are tested then we will know the incidence of the spread of the disease. Tamil Nadu has 54,000 to 55,000 cases till date and it adds almost 1500 people every day. But then the number of testing labs are increasing, so more testing will happen," he said.
But the low mortality rate should not make state authorities complacent, as Dr Kumarasamy clarified, "The mortality of Tamil Nadu is at 1%. It used to be 0.6% two weeks ago. The climb has been steep because we've seen a lot more elderly people coming in who have co-morbidities like diabetes, hypertension, renal disease and obesity which add to the mortality rate."
Dr Savio gave more details on the critically ill patients—30% of the overall infected people require ICU admissions or a high dependency unit. Roughly 10% end up requiring the mechanical ventilator and these are the patients who account for the mortality rate.
Dr Savio says that beds for the critically ill are maximally stretched, but between the public and the private sectors face different issues. "Critical care patients need a longer duration of stay in the ICU and that is where the issue of beds comes in. Though the public sector has more beds and equipment, it lacks specialist personnel, who are more probably more concentrated in the private sector where bed strength can be maximally stretched," he said.
But then Dr Kumarasamy points out that though the cases of COVID-19 are increasing in Chennai, hospitals can't solely be used for COVID-19 patients. "The government has requested almost 30-40% of the total bed strength can be allotted to COVID. The rest should be allocated to cancer, HIV, patients and TB patients," he said.
The spike in cases has left Dr Kumarasamy worried about running out of beds if the pandemic continues to increase beyond July. "Again, the question is are we really prepared to take care of everybody if the numbers continue to go up beyond July," he said.
Highlights
-Chennai has a high prevalence of confirmed COVID-19 cases, but it has a lower mortality rate as compared to Delhi and Mumbai. One of the reasons for this is the COVID-19 confirmed cases are not concentrated among the elderly with comorbidities.
-Private and public hospitals in Chennai lack facilities to take care of critically ill COVID-19 patients. Private hospitals lack beds for the critically ill patients while public hospitals lack specialised personnel to deal with critical cases.
-The true incidence of the spread of COVID-19 will only be known if more people are tested.
Catch the full interview on YouTube or click on the link here.